James Reilly (Dublin North, Fine Gael)

I will not be providing Deputy Ó Caoláin with copies of that information. This is a consultation process that will be predicated on safe clinical practice, but also on the principle, to which I alluded in the previous answer, around the smaller hospital framework. If we are going to have a situation where we want the larger hospitals that have that received investment to deliver the tertiary services and the regional services, such as neurosurgery and cardiac surgery, then we must advise patients that they should be going to their local hospital for the ordinary procedures, such as gall bladder, varicose veins and inguinal hernia repair.

People should attend third or fourth level hospitals only where there is serious comorbidity and risk.

All Deputies are exercised about the future of small hospitals. I want to ensure smaller hospitals have a vigorous and full workload, are performing procedures and providing services that are safe, while leaving more complex procedures to larger hospitals. I will not tolerate large hospitals trying to hold on to all their services, as has been the case in the past. They may be good at accepting new services, especially in areas such as cancer care, but they are reluctant to transfer other services to smaller hospitals. Member do not agree with that approach.

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